Referrals and Eligibility Specialist

Twin Cities Pain Clinic•Edina, MN

22h•Onsite

About The Position

The Referrals and Eligibility Specialist is responsible for coordinating and supporting a wide range of clinical and administrative functions, including patient scheduling, insurance verification, and referral management. This role ensures efficient clinic operations and a seamless patient experience by managing eligibility processes, authorizations, and communication with patients, providers, and insurance entities.

Requirements

High School Diploma or GED required.
Minimum of one year of proven strong customer service, scheduling, and phone skills required.
Minimum of one year of healthcare office experience with insurance eligibility required.
Good writing, analytical, and problem-solving skills.
Exceptional ability to listen and communicate to others.
Ability to prioritize duties.
Ability to follow oral and written instructions.
Ability to operate standard office equipment.
Strong computer skills.
Ability to work well whether independently or as part of a team.
Knowledge of principles and practices of basic office management and organization.

Nice To Haves

Bachelor’s Degree preferred.

Responsibilities

Schedule new patient appointments and accurately enter information into the electronic scheduling system.
Verify insurance eligibility and benefits for clinic and surgical services to ensure coverage is active and billable.
Assist patients with insurance-related inquiries and correspondence.
Obtain and verify required referrals and prior authorizations.
Investigate and resolve insurance and benefit discrepancies.
Communicate effectively with referring providers and clinics.
Coordinate the collection of medical records prior to patient consultations.
Collaborate with workers’ compensation representatives and auto insurance adjusters to secure necessary authorizations.
Ensure timely progression from referral receipt to initial patient consultation.
Maintain compliance with organizational policies and HIPAA regulations to protect patient confidentiality.
Perform additional duties and responsibilities as assigned.